Patient with unilateral hearing loss and a mass in the middle ear. Schwannoma is suspected. Biopsy is shown. Short thread follows...
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The lesion is composed of cells arranged in solid sheets, often with a plasmacytoid appearance, also occasional glandular structures. Mitotic figures are hard to find. No necrosis.
Cells are strongly immunoreactive to chromogranin A. Also positive for synaptophysin and INSM1 (not shown). Could this be a paraganglioma?
So, an epithelial neuroendocrine tumor then! But wait, is this a metastasis from somewhere? Or could it be a primary lesion? Here is SATB2! 🧐